Healthcare Provider Details

I. General information

NPI: 1598274656
Provider Name (Legal Business Name): SVEINN BJORNSSON DR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LENOX POINTE NE STE A
ATLANTA GA
30324-7418
US

IV. Provider business mailing address

17 LENOX POINTE NE STE A
ATLANTA GA
30324-7418
US

V. Phone/Fax

Practice location:
  • Phone: 404-634-0201
  • Fax: 404-634-0201
Mailing address:
  • Phone: 404-634-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number009933
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: